An Unusual Heartbreak

I had a long struggle last night. I needed to send an email to my boss, and I sat in bed for over an hour with the mouse hovering over the "send" button. I knew I needed to send her this email, but I didn't really want to. I cried.

Because my heart is breaking just a little bit. Maybe a lot bit.

You see, I found out yesterday that I officially need to move in order to finish my schooling. It is something that I've been anticipating, but over the last few weeks I wasn't quite sure when or where I would actually need to move...it could have been in a few weeks, it could have been August. It could have been California, it could have been North Carolina - due to a lot of uncontrollable factors I just didn't know. Maybe I wouldn't even have to move at all.

Yesterday a miracle happened and I finally got a preceptor for my clinical course this summer (several weeks behind schedule). After meeting her and her staff, I feel unbelievably lucky to do my rotation there and that she was so willing to take me as a student at the last minute. But in order to do my rotation with her, I have to relocate - her office is located five hours away, and I can't afford to make that commute every week. Not to mention that from here on out, my school load is increasingly heavier because I added extra classes and clinical to my curriculum.

So last night, I sent my letter of resignation to my boss. And I totally cried.

I'm going to really miss being a bedside nurse. Ever since starting my master's degree, I find myself feeling a little nostalgic at work and trying to savor all of the sweet experiences that I have there, because they now need to last me a lifetime. There's something about being there for a baby's first breath, their first bath, answering questions of anxious first time parents and teaching them how to swaddle a baby, making friends and joking with the patients and their families. There's something about feeding a baby in the NICU at 3 am, and being there for the little babes when their parents can't be there.

When I worked in pediatrics, I was always amazed at the enthusiasm of these little kiddos - how brave they are and how they try not to let things get to them. I even got to take care of two little guys on peds that I took care of for a couple months in the NICU...and even though they weren't my children, I was so excited to see them again and how much they were growing and progressing. The kids get so excited to tell you that they ate their whole popsicle or finally were able to go to the bathroom, or they show you their cool new toys and brightly-colored shoes. And it's kind of fun when they flash you a toothless grin when they make their daily walk around the nursing unit.

I remember feeling so overwhelmed as a nursing student in the hospital, and now the hospital is like home to me. My coworkers are my second family. And it rips at my heart to have to leave. Truly, hospitals have become such a special, special place to me and I don't quite know what I'll do without it.

I still am really excited about being a nurse practitioner, and this is where I've always wanted to be. But since the type of nurse practitioner certification I'm pursuing doesn't yield many hospital positions, I am wrestling with my farewell to the inpatient world.

And just because I'm hanging on to every last bit, I want to share some videos with you...there are so many of them on YouTube, but these two stuck out to me this week.

This first one, tear jerker for sure. It's patients and families like these that keep you coming back to work.

This one may take place in the ER, but they are the types experiences nurses on every unit will go through on a daily basis. You never know what's going to walk through the door, and you're there to take care of a patient at a very vulnerable time.

My journey of becoming a nurse is easily one of the best things that's ever happened to me. I'm so grateful that I'll always get to carry "RN" behind my name. 

Life Keeps on Moving, Anyway

I will never forget my first night on the unit as a labor & delivery nurse. 

I will be honest, I was terrified. It wasn’t a job I took because I wanted it; it was a job I took because I needed a job. Even though I had been a nurse for almost three years, I didn’t know much about labor and delivery. I knew enough to be scared. I knew that it was a high risk area and that things could go so very wrong in the blink of an eye. I didn’t like losing an element of control…there’s only so much you can do to try and fix a baby while it is still inside its momma. I would have felt much more comfortable back in the NICU where I could actually touch the baby!

Fear and apprehension aside, a small part of me was excited to learn something new. I was curious as to what my new role would look like.

I had seen deliveries a few times before. As a nursing student I got to see a few, and then on a few occasions as a nursery nurse I got called to labor & delivery to assist with the baby immediately after birth. But none of that resembled anything close to my experience my first day on L&D.

It was a night shift in late March, and my work started at 6 pm. The patient I assumed care of had been admitted earlier in the day after her water broke. She had been laboring for several hours, and decided to get an epidural shortly after I got on shift. The amount of support I needed to provide to my patient during labor was minimal after that…we allowed her to rest and my preceptor began teaching me things I would need to know. Around 10 pm, my preceptor and I went to do a cervical exam to see how much progress our patient had made. She was dilated to 10 cm (which we term “complete,” meaning the cervix has completely dilated to allow the baby to pass through the birth canal). After the exam, I felt my adrenals kicking in. This woman would be having her baby soon. And I was going to get to be a part of the whole thing.

When it was time to start pushing, I stood on one side of the patient’s bed as her husband stood on the other. Together, we supported my patient’s legs as my preceptor coached her through pushing. I offered words of encouragement and support as we continued, and soon became overwhelmed with gratitude and humility for the opportunity to participate in such an event. The moment this child would be born would be a moment that would forever change the course of the future. As I watched this momma give everything she had to bring this child into the world, I choked up a little on the inside. There I stood, in the same position as many women throughout the history of the world, as they assisted other women in their villages and communities with childbirth. For thousands of years they had done exactly as I was doing on that night, and I felt the strength, unity and power that comes with that kind of sisterhood. The gravity of that moment was not lost on me.

A year later, I am still a little in awe that I get to be a part of this every week as my job. I get paid to help women have babies. I get to help coach them through labor, answer their questions, and eventually assist in bringing their baby into this world. I get to help them feed their baby and answer their questions about their baby’s health. I get to teach them about all of the changes that their body is going through and what to expect in the postpartum period. I get to be an advocate, encourager and friend. This is my job. And I couldn’t be more grateful for it, even on the hard days.

I find great joy in helping a woman through her labor or c-section, and helping her and her partner fully experience (as far as they wish it) this process at a time that is so uniquely theirs. It is a job that is all about encouragement.

Of course, it isn’t always easy. Despite all of the advances that we have in modern medicine, there is a significant level of “uncontrollable-ness” in regards to conception, pregnancy, and delivery. Not everyone gets to have a baby when they want to, and not everyone gets to have a baby. Not everyone has a healthy pregnancy and delivery, and not everyone gets a healthy baby.

Those are the tougher moments of my job…knowing what to say and what not to say as a mother comes in to deliver a baby that has passed while still in her womb. Knowing how to comfort a father as his wife is whisked away for an emergency c-section in which the outcome for both wife and child is unknown. Knowing how to tell new parents “your baby is struggling a little bit” as the baby is transferred to intensive care. Knowing how to be there for your patient and continue the necessary care after the physician delivers a terrifying diagnosis or any kind of bad news.

This is what I signed up for.

The good and the bad.

And to be a good nurse through all of it. To not have my emotions compromise what needs to be done.

As a nurse I juggle between mourning with those that mourn, comforting those who stand in need of comfort - and then again find joy and excitement in the next moment to celebrate with those who are in a season of joy. It is sometimes particularly difficult for me to change composure like that only in the time it takes to walk from one room to the next. I never know what I'm going to walk into when I go to work, and it would be easier to just turn all the emotion off. But I'm still human, and how can I not feel joy at the birth of a baby or feel sorrow during some sort of loss? Being a "professional" in these instances doesn't make me immune to those traits that come with being a living soul. Nursing for me stands at the precipice of human emotion, and it is the pinnacle of my humanity.

If anything, working in labor & delivery has taught me that life keeps on moving anyway, no matter the struggle. A minute, an hour may feel like eternity – but it always passes. And even when it feels like you can’t take it any longer, I promise you that you can. Just one more minute. You can do anything for 60 seconds. And even if you have to take it one minute at a time, that minute will eventually pass. You were born to handle this, and you are stronger and more capable than you know. Keep pushing forward, don’t give up, and life will keep on moving.

It Doesn't Take a Stethoscope

To be honest (in a totally cliche way), my decision to become a nurse has forever changed me. My experiences in the hospital are embedded so much into the way I view and live my life. There are good days and bad days, and both can be hard to talk about. I often long to share these experiences with others but some things are not appropriate to discuss due to patient confidentiality. After reading a stranger's post on Facebook this morning in context of one of my shifts in the NICU earlier this week, I bawled (read it here, it was so touching).

There are some things that need to be said. **Reader discretion advised if you are pregnant**

There has been quite a frenzy in the media this past week or two about "The View" and the careless comments that were made about Miss Colorado's talent for the Miss America pageant. I admit, I was among those upset (however, it was really awesome to see nurses rally together to defend Miss Colorado and our profession). I enjoyed all of the memes on Facebook and we joked at work about how it's usually the doctors asking to borrow our stethoscopes. But after one of my shifts in the NICU this week, I had other thoughts (and while this post focuses mostly on my experiences with babies, I've had similar experiences with adults).

source here

Though stethoscopes are certainly essential to my work as a nurse, I find that does not really define the magnitude of my responsibilities as a nurse.

No, Joy Behar, my issue with you is not about the stethoscope.

It doesn't take a stethoscope to hear the anguished cries of a mother as she's in labor. It doesn't take a stethoscope to hear a baby's first cry after delivery. It doesn't take a stethoscope to hear the excitement of new mothers and fathers as they speak and whisper words of joy to their new little one.

By the same token, it doesn't take a stethoscope to hear "One and two and three and breathe" as the bag and mask is repetitively inflated to help a baby breathe, and chest compressions are given at a steady rate as a baby is resuscitated. It doesn't take a stethoscope to hear continuous beeping from alarms on the machines telling you that the resuscitation isn't effective enough. It doesn't take a stethoscope to hear the frantic footsteps of people running to grab blood products or the crash cart.

I have run down hospital hallways to make it to the bedside as quickly as possible. I have clumsily rushed to put together a bag and mask and attach it to oxygen for a baby that's blue. I have sat in the nursery at two in the morning with other staff and cried after our failed 3 hour infant resuscitation. I have held the hand of a mother whose baby was born with a terminal condition and shouldn't have survived delivery; I rocked the infant by her bedside so she could sleep for a few hours with the assurance that her baby was being held should he pass. I've seen the perfect little face of a stillborn baby who should have gone home with mom and dad.

source here

This week I had a sobering shift in the NICU. For nearly four hours I watched nurses literally running at full speed, back and forth from our unit and the lab, with fluids needed for a critical infant. I cringed at the sound of their pounding feet down the hallway and my heart ached. There was a particular silence and reverence that night on the unit among my coworkers and I as this baby was slowly dying. In comparison, my babies were progressing well. They weren't well enough to be home just yet, but they were going to be fine. They were going to go home. As I did their cares and fed these tiny babies that night, I was just a little more gentle and tender and whispered them words of encouragement and love.

These stories are the lives of your family, friends, neighbors, and community members, no matter where you may live. Their stories do not often get shared. Somewhere some parent is aching and longing to snuggle, feed, and change diapers of a baby they shouldn't have had to lose. Maybe it's the baby who lost a mother. You may know them personally, or they may be the person you pass in the frozen food aisle at the grocery store.

We don't always know what someone else is going through. My hope however, is that we can all be a little bit kinder and more forgiving and gentle with each other.

I would extend the invitation to think of these people today, and keep an extra prayer in your heart for them to have strength and courage in this unbelievably difficult challenge they have to bear. To these very special parents - I have no idea what it must feel like, but I hope you know that I ache for you and cry with you. And it doesn't take a stethoscope to do that.

Little Little Babes

Be prepared for an overload, I started orienting in the NICU this last week... And a nice little lullaby to set the mood :)



When I worked in Idaho, one of the charge nurses arranged during my orientation for me to watch an emergency c-section of a 27-week gestation baby. It was the coolest thing I've ever seen. This little baby was barely past the age of viability...most little kiddos born before 24 weeks of gestation just aren't developed enough to survive, and even at 24 weeks it's going to be a long, long road. So there I stood in the stabilization room and watched as the OR team passed this teeny tiny baby through a window in the OR to the NICU team in the stabilization room. Work immediately commenced to intubate, start an IV, draw labs, and various other tasks to stabilize the baby. She did surprisingly well, but I remember standing in awe as I looked around at this team of people - two NICU nurses, a neonatal nurse practitioner, a neonatologist, a pharmacist, a respiratory therapist, a radiology tech and nurse's aide - all coordinating their care so smoothly to make sure everything went as it was supposed to. It was like watching a really well-coordinated dance. Everyone knew their part and they just did it, and they knew what to do to save this little girl's life. I already wanted to work in the NICU, but I really fell in love with it that day.

I was elated to start a new float job in Utah where part of my assignments would be in the NICU. I started this last week, and it has been quite the adventure. I knew things were different than my term-babies and there were special considerations to take into account for preemies, but it has been surprisingly difficult to change diapers, swaddle, and move babies for bottle feeding. You have to get as much done as you can with as little movement and stimulation as possible, and it is quite the task!

But after a week I'm finally starting to feel a little more comfortable. Not that I'm good at it yet, but I don't feel so much like a fish out of water in the NICU.

This is what I get to see at work :)




The last couple of days I got to take care of the same three kiddos, including a set of twins. All three babies were born about two months early, they were darling. It was amazing to me to see these tiny little babies wake up and interact with you even though they shouldn't have been born until August...I could still definitely see character and personality in all three of them. To me, it just helped me realize what a true miracle each and every life is, and how precious they really are.

We worked a lot - a lot - on feedings since their reflexes to suck and swallow weren't developed when they were born. As their brain continues to grow and develop, we have to help them learn those things that full-term babies come wired to do. Most preemies have feeding tubes to help them get adequate nutrition.

Towards the end of my shift last night I was getting ready to do cares and start the last feeding of one of the twins. She definitely was the strongest and most feisty of the two, even though she was only four pounds. As I went to unwrap her, I noticed her feeding tube was gone. I looked through her blankets and all over her crib for it until I finally found it on the floor. Not only had she yanked it out, she managed somehow to get it on the floor! My preceptor and I had a pretty good laugh at that. Not surprisingly, this little babe didn't appreciate me putting a new feeding tube put in...hopefully she doesn't pull it out again!

My preceptor and I finished what needed to get done a little bit early before we had to give report to the oncoming nurse, so she took me over to give me a tour of the critical care side of the NICU. Most of those babies were on breathing machines as big as I was, with several different monitors and leads and IV drips hanging. Those nurses were pretty busy since there were 5 baby codes on Labor & Delivery that night. It is amazing to me what can be done to help all these little, little babies. Honestly and truly, some of them looked not much bigger than my hand.

Anyway. I apologize for my rambling words, but I wish you could all see what I get to see by being a nurse! The hospital is an amazing place. Truth be told, I even kind of miss med-surg sometimes. I would never work there, but there are a lot of miracles that go on there too, and very special people. Even though it's often stressful, the hospital is like a second home to me. Even with all the beeping and noises from the different machines and monitors, it is a reverent and sacred place. It's all about taking care of people, and that's a great line of work to be in.

Love to you all.

The Truth About Nursing

My heart is so full, full of good things.

Tonight is my last shift being on orientation at work. It has caused me to reflect on whether or not I feel ready for that…and I mostly do. I will never know everything and I will continue to always ask questions, but I have to start somewhere.

Nursing is not exactly what I thought it would be when I decided to pursue that career path. After I started I quickly learned "the truth about nursing" that nurses seemed to often complain about - food and bathroom breaks are rare, you get yelled at, you're going to make at least one medication error, and you'll never have enough time to spend the quality time with your patients that you would like to. But I have discovered more important truths about my job.

There is a lot of technical and analytical work that goes into nursing. We have to make sure all the lines and tubes are going the right places with no kinks or bubbles or leaks, verify that the correct medication is infusing at the appropriate dose and rate, we change surgical dressings, monitor for and prevent infections, and a hundred other nursing "tasks." At work I have to observe my patients carefully to make sure our mommies aren't having hemorrhage complications after delivery, or that our babies aren't silently gagging from fluid that hasn't cleared their lungs or stomach. You have to be aware of a lot of things - we are watching and observing for more things than our patients probably realize - but there is so much more to our job than that. I would even suggest that while these things are critical nursing skills and what we are educated at school for, that is not the drive behind our profession.

There are no words to describe the looks on a parent's face when they get to see their newborn for the first time or hear their newborn cooing sounds. Grandparents come in beaming and brag to the nurses that the birth of their grandchild introduced the cutest kid on the unit award. Siblings get to hold their new brother or sister and stare intently into their faces as if they don't really understand who this little being is and where they came from, but all they want to do is cuddle and kiss it anyway.

And then there are the not so fun things, like watching a fetal monitoring strip during labor that indicates severe fetal distress before you finally hear "Stat section for vasa previa." Babies get transferred to the NICU. Mothers hemorrhage or seize. Sometimes the babies don't make it.

People don't plan for things like that.

Nurses work within a realm of very personal, private, and often emotional human experience. We take care of people on their good days and on their worst days, and when they find themselves in a state of vulnerability from which they cannot escape. There are moments of joy, but also moments of fear from the unknown. My work as a nurse is deeply rooted in these facets of the "human experience."

Even though I am a new nurse with little experience, I would bet that there are seasoned nurses that agree.

I am a little hesitant to share thoughts about this that are so personal to me. Instead, I do want to share a few videos that I think capture the essence of my experience in nursing. These are the things that my heart is full of.


Nurses Federation from Jason Wingrove on Vimeo.


Ward Miles - First Year from BenjaminScot on Vimeo.

"These mortal challenges allow us and our Heavenly Father to see whether we will exercise our   agency to follow His son. Yes, weeping may endure for a night, but joy cometh in the morning… Let us not give up on the Lord. His blessings are eternal. "

In all these things, in all our experiences, we are all children of God getting to experience humanity together. That is what my job is all about. It is intensely personal and sacred. There is always an opportunity to reach out and serve. This work draws me closer to my Heavenly Father and Savior.

This, my friends - this is nursing.